EP0493789A1 - Verfahren und Vorrichtung zur Osteosynthese - Google Patents

Verfahren und Vorrichtung zur Osteosynthese Download PDF

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Publication number
EP0493789A1
EP0493789A1 EP91122197A EP91122197A EP0493789A1 EP 0493789 A1 EP0493789 A1 EP 0493789A1 EP 91122197 A EP91122197 A EP 91122197A EP 91122197 A EP91122197 A EP 91122197A EP 0493789 A1 EP0493789 A1 EP 0493789A1
Authority
EP
European Patent Office
Prior art keywords
tube
fixation
vent
liquid
bone
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP91122197A
Other languages
English (en)
French (fr)
Other versions
EP0493789B1 (de
Inventor
Milan Krajicek Csc. Mudr.
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Individual
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Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP0493789A1 publication Critical patent/EP0493789A1/de
Application granted granted Critical
Publication of EP0493789B1 publication Critical patent/EP0493789B1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A61B17/7233—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7266—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00535—Surgical instruments, devices or methods pneumatically or hydraulically operated
    • A61B2017/00539—Surgical instruments, devices or methods pneumatically or hydraulically operated hydraulically
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
    • Y10S623/92—Method or apparatus for preparing or treating prosthetic
    • Y10S623/923—Bone

Definitions

  • the present invention relates to a method and a device for the osteosynthesis of bones by the method of intra-marrowial cavity fixation.
  • the method of the present invention which can also be used without relation to the surgical or therapeutical treatment of the human and animal body, for example for research and development purposes, animal tests, etc. - is characterized by the following steps:
  • the fixation part has a dowel-like form and is expandable, e.g. by inserting the vent part from its uncut end for fixing it in the access hole of the bone and for a tight connection with the tube.
  • the cut portion of the dowel-like fixation part preferably comprises at least one longitudinal slot, these slots preferably being regularly arranged over the circumference.
  • the fixation part of the device comprises an internal thread
  • the vent part comprises an external thread fitting into the internal thread of the fixation part, the vent part preferably being provided with a slot groove at its outer end.
  • the internal portion of the fixation part and the outer portion of the vent part are designed to form a bayonet joint for tight fixation of the vent part in the fixation part.
  • the means for connecting the liquid line to the vent part preferably are an internal thread provided in the vent part, a flange or a sleeve.
  • the tube of the device is preferably made of or comprises polyethylene, polyurethane and/or polytetrafluoroethylene.
  • the fixation part is preferably made of a solid, inert and sterilizable material, advantageously of a metal or a metal alloy.
  • the device according to the present invention further comprises means for pressurizing and supplying and draining the filling liquid, designed to be connected via the liquid line to the vent part of the connection part, for filling the tube at a predeterminable pressure, preferably within the range of 200 to 1000 kPa, and to be disconnected therefrom.
  • the liquid used for filling the tube is preferably a biologically inert, sterilizable liquid, advantageously water, a gelatine solution or a dextran solution. It may optionally comprise a radio-opaque material, preferably an iodine or an iodide solution, for producing a sufficient X-ray contrast.
  • kits of parts comprising a device as defined above and a biologically inert, sterilizable or sterilized liquid provided to be introduced into the tube of the device and to be released therefrom after the healing period of the bone.
  • kits of parts may further comprise means for pressurizing and releasing the liquid through a line connectable to the vent part of the device, preferably comprising pumping means such as a peristaltic pump, a liquid reservoir, valves and a pressure gauge.
  • the basic advantage of the concept of the present invention is the application of the physical principle of non-compressibility of liquids.
  • the tube made of a non-elastic, pliable material is inserted through the access hole by means of an insertion instrument preferably made of a metal or a metal alloy, and preferably being rod-like and having a rounded end.
  • the tube is fixed in the access hole of the bone, e.g. by the dowel-like fixation part into which the vent part is firmly inserted thereafter.
  • the system is filled under a predetermined pressure, preferably using a biologically inert liquid as defined above.
  • the necessary rearrangement and adjustment of the bone fragments may be performed, which represents a considerable advantage.
  • the predetermined maximal pressure within the tube inside the marrow cavity of the bone has been reached, a perfect cast has been formed, the stability and tenacity of which is comparable to any type of nail and/or rod fixation.
  • the removal of the device after the healing period is very simple, because after release of the liquid, the other parts of the device, i.e. the connection part and the tube, may be removed without any problem.
  • the device according to the present invention leads to a significant simplification of the whole procedure, which is of highest surgical and therapeutical value because the operation time can be significantly reduced, less drillings of bones are necessary, the total instrumentarium is extremely simple and universally applicable, and the infection risks are minimized particularly due to the reduction of the surgical operation time and the reduced number of drillings. Furthermore, the substantial reduction of costs involved leads to considerable savings regarding both the method and the device and materials.
  • the device comprises a tube 2 made of a non-elastic, pliable but strong material.
  • the tube 2 may be inserted by means of an insertion instrument 3 into the marrow cavity of a bone 1.
  • the tube 2 is preferably made from a biologically inert, sterilized material, for example of polyethylene, polyurethane and/or polytetrafluoroethylene.
  • One end 2' of the tube 2, i.e. the internal end, is sealed, and the other end is open.
  • the fixation part 4 is introduced for the fixation of the tube in the bone 1, and for a firm connection to the fixation part.
  • the fixation part 4 as shown in Fig. 2 comprises a longitudinal slot, allowing an expansion of the dowel-like fixation part, as may be seen from Fig. 4.
  • the tube 2 is filled with a biologically inert, unobjectionable sterile liquid 10, for example water, gelatine solution or dextran solution, advantageously under a pressure of 200 to 1000 kPa.
  • a biologically inert, unobjectionable sterile liquid for example water, gelatine solution or dextran solution, advantageously under a pressure of 200 to 1000 kPa.
  • the fixation part 4 is preferably dowel-like, as shown in Figs. 2 and 4, and its non-cut end is provided with an internal thread 5 fitted to the external thread 6 of the vent part 12.
  • the cut end of the fixation part 4 is provided with at least one longitudinal slot 4', these slots preferably being regularly distributed along the circumference of the fixation part 4.
  • the fixation part 4 and the vent part 12 of the connection part 13 preferably are of round, mainly cylindrical shape.
  • the fixation part 4 is preferably made of a metal, solid, inert and sterilizable material.
  • the external thread 6 of the vent part 12 serves for screwing the vent part 12 into the internal thread 5 of the fixation part 4.
  • the vent part 12 is further provided on its outer end with a slot groove 7 and comprises an internal thread 8 for the line 14 (Fig. 5) for the liquid 10.
  • the line 14 may be connected to the means for pressurizing and releasing the filling liquid 10.
  • the vent part 12 comprises a vent 9 which advantageously is a returnable ball vent.
  • the vent 9 is preferably provided in the middle part of the vent part 12.
  • the tube 2 is filled with the liquid 10, preferably comprising a radio-opaque material, for example an iodine solution.
  • the non-elastic, pliable but strong tube 2 with sealed internal end is introduced into the marrow cavity of a bone 1 having a transversal fracture 11.
  • This tube 2 is inserted by means of the insertion instrument 3 (Fig. 1), advantageously made of a metal or metal alloy.
  • the fixation part 4 of dowel-like form is then inserted into the open end of the tube, wherein the pressure exerted by the preferably expanded fixation part guarantees the firm fixation of the tube 2 in the access hole of the bone 1 and the tight connection between the tube 2 and the fixation part 4.
  • the surplus part of the tube 2 is cut off.
  • vent part 12 provided with an external thread 6 is firmly screwed into the internal thread 5 of the fixation part 4.
  • the screwing of the vent part 12 into the fixation part 4 may be facilitated by the slot groove 7 provided at the outer end of the vent part 12.
  • the vent part 12 comprises in that end portion an internal thread 8 into which a line, flange or sleeve may be screwed in for connecting the line 14 for the liquid 10 from and to a pressure pump.
  • the vent part 12 is further provided with the vent 9, for example with a returnable ball vent.
  • the vent part 12 also provides the internal mechanism for expanding the dowel-like fixation part 4 by screwing-in.
  • the device according to the present invention may also be inserted into long bones 1 having a transversal fracture 11 because the length of the tube 2 may be easily adapted to the respective length of the marrow cavity of the bone 1.
  • Fig. 5 shows the fixation of the tube 2 in the access hole of the bone 1 by means of the fixation part 4 of the connection part 13.
  • Fig. 5 further shows the line 14 through which the liquid 10 is introduced into the tube 2 and released therefrom after the healing period, prior to simply withdrawing the tube through the access hole.
  • the connection part 13 accordingly allows an easy inflow and outflow of the filling liquid 10 which is introduced for osteosynthesis under a predetermined, suitable pressure.
  • the tube 2 of the device of the present invention forms, after insertion into the bone, a kind of solid mould, with an ideal adaptation of its shape to the natural internal form of the marrow cavity. After the filling procedure the line 14 to the pressure pump is disconnected from the connection part 13. After the fracture 11 is healed, the whole device may be easily removed from the bone after release of the liquid 10.
  • the concept of the present invention represents a significant technological and surgical advance in the field of osteosynthesis.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
EP91122197A 1990-12-29 1991-12-23 Vorrichtung zur Osteosynthese von Knochen Expired - Lifetime EP0493789B1 (de)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CS906878A CS277533B6 (en) 1990-12-29 1990-12-29 Fixed osteaosynthesis appliance
CS6878/90 1990-12-29
US07/821,095 US5303718A (en) 1990-12-29 1992-01-15 Method and device for the osteosynthesis of bones
JP4006715A JPH05220173A (ja) 1990-12-29 1992-01-17 骨接合のための方法および装置

Publications (2)

Publication Number Publication Date
EP0493789A1 true EP0493789A1 (de) 1992-07-08
EP0493789B1 EP0493789B1 (de) 1997-03-26

Family

ID=27179535

Family Applications (1)

Application Number Title Priority Date Filing Date
EP91122197A Expired - Lifetime EP0493789B1 (de) 1990-12-29 1991-12-23 Vorrichtung zur Osteosynthese von Knochen

Country Status (6)

Country Link
US (1) US5303718A (de)
EP (1) EP0493789B1 (de)
JP (1) JPH05220173A (de)
CS (1) CS277533B6 (de)
DE (1) DE69125359T2 (de)
DK (1) DK0493789T3 (de)

Cited By (16)

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EP0741547A4 (de) * 1994-01-26 1998-02-11 Mark A Reiley Verbesserte aufblasbare vorrichtung zur verwendung in chirurgischen protokollen im bezug auf die fixierung von knochen
US6129763A (en) * 1996-09-13 2000-10-10 Chauvin; Jean-Luc Expandable osteosynthesis cage
WO2004030549A1 (de) * 2002-10-01 2004-04-15 Synthes Ag Chur Vorrichtung zur knochenfixierung
EP1464293A1 (de) * 1994-01-26 2004-10-06 Kyphon Inc. Verbesserte aufblasbare Vorrichtung zur Verwendung in chirurgischen Protokollen im Bezug auf die Fixierung von Knochen
EP1011464A4 (de) * 1997-03-07 2006-01-04 Mordechay Beyar Systeme zur perkutanen knochen und wirbelstabilisirung,befestigung und reparatur
US8491591B2 (en) 2001-11-03 2013-07-23 DePuy Synthes Products, LLC Device for straightening and stabilizing the vertebral column
US9259696B2 (en) 2005-11-22 2016-02-16 DePuy Synthes Products, Inc. Mixing apparatus having central and planetary mixing elements
US9289240B2 (en) 2005-12-23 2016-03-22 DePuy Synthes Products, Inc. Flexible elongated chain implant and method of supporting body tissue with same
US9642932B2 (en) 2006-09-14 2017-05-09 DePuy Synthes Products, Inc. Bone cement and methods of use thereof
US9707095B2 (en) 2014-06-04 2017-07-18 Wenzel Spine, Inc. Bilaterally expanding intervertebral body fusion device
US9839460B2 (en) 2003-03-31 2017-12-12 DePuy Synthes Products, Inc. Remotely-activated vertebroplasty injection device
US9918767B2 (en) 2005-08-01 2018-03-20 DePuy Synthes Products, Inc. Temperature control system
US10039585B2 (en) 2003-06-17 2018-08-07 DePuy Synthes Products, Inc. Methods, materials and apparatus for treating bone and other tissue
USRE47427E1 (en) 1999-01-27 2019-06-11 Medtronic Holding Company Sárl Expandable intervertebral spacer
US10660762B2 (en) 2013-09-12 2020-05-26 DePuy Synthes Product, Inc. Minimally invasive biomaterial injection system
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CS277533B6 (en) 1993-03-17
DE69125359T2 (de) 1997-07-03
EP0493789B1 (de) 1997-03-26
DE69125359D1 (de) 1997-04-30
US5303718A (en) 1994-04-19
DK0493789T3 (da) 1997-10-13
CS687890A3 (en) 1992-08-12
JPH05220173A (ja) 1993-08-31

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